Rhinoplasty and Surgery on the Older Nose

Nose jobs are appropriate for people in their teens to senior citizens. But there are some special considerations in plastic surgery on the older nose. As we age – and with the help of gravity – many older noses also droop and appear longer and less attractive.

Those noses also tend to develop humps on the middle part of the nose.

So the surgeon must carefully consider the following about older rhinoplasty patients:

• Current medical problems
• Medications taken
• The patient’s expectations from surgery

Writes Rod Rohrich, M.D. a Texas board-certified plastic surgeon who has authored technical articles on performing the mature rhinoplasty: “Less is indeed more; mature patients do not want the big changes wanted by younger patients.”

Dr. Rohrich was president of the American Society of Plastic Surgery from 2003 to 2004 and is professor and chairman, department of plastic surgery at the University of Texas Southwestern Medical Center.

It’s an important topic because the first of the huge numbers of baby boomers (everybody born between 1946 and 1964) will fill doctors’ offices in two years. Perhaps you’ve read that baby boomers are not retiring like previous generations and often take up new careers.

Facial makeovers to look more energetic, rested and refreshed are often part of that boomers new career.

Nonetheless, all that energy and ambition is contained in a 65-year-old body!

Sometimes, the rhinoplasty surgeon finds, as the nose droops and grows longer, the internal nasal valve is also pinched, restricting breathing.

Solution? The surgeon uses a technique known as spreader grafts to safeguard the airway.

A piece of donor cartilage is inserted in the middle part of the nose to prop the nostrils open.

The surgeon also must carefully consider how the passing decades and gravity have affected changes in the patient’s skin, cartilage and the bony framework inside the nose.

To make the older nose look better the surgeon usually must:

• Bring up and straighten the tip
• Lengthen the columella, the strip of skin between the nostrils

Experts also say older patients heal more slowly and might have bruising and tenderness longer than younger patients.

If the patient is really concerned about his or her appearance, a neck lift or chin augmentation might also help improve the person’s facial profile.

Another bright idea: find a surgeon who has done many older noses!